Laboratory billing services
Technology and managed revenue cycle together. The platform builds the claim from the order the laboratory actually ran; our team works eligibility, submission, denials and accounts receivable against it.
What the platform does, and what people do
This distinction is worth being precise about. One is a capability you configure; the other is trained staff doing work inside it.
The platform provides
- Claim assembly from the validated order record
- Eligibility, claim status and ERA workflows
- Denial, AR aging and payer analytics dashboards
- Work queues prioritized by what blocks payment
Our team does
- Insurance verification and eligibility resolution
- Claim preparation, scrubbing and submission
- Denial follow-up and appeals support
- AR follow-up, payment posting and reconciliation
What is covered
Insurance verification
Coverage confirmed and unresolved payers investigated before the claim goes out.
Claim preparation and submission
Claims assembled, scrubbed against payer rules and submitted through the clearinghouse.
Claim tracking
Status followed from submission to adjudication, with stalled claims surfaced rather than forgotten.
Denial follow-up
Denials worked by reason and payer, with repeating causes escalated to be fixed upstream.
AR follow-up
Aging worked systematically by bucket, payer and balance rather than by whoever calls first.
ERA, EOB and posting
Remittance processed, payments posted and reconciled against expected reimbursement.
The engagement, in four steps
Nothing here starts with our staff guessing at your rules. It starts with documenting them.
- 01
Assess
We review current billing performance, payer mix, denial reasons and AR composition.
- 02
Configure
Payer rules, fee schedules, work queues and escalation paths are set up in the platform.
- 03
Operate
Our team works eligibility, submission, denials and AR inside your platform and your audit trail.
- 04
Report
Performance is reported against agreed measures, with upstream causes fed back to operations.
Billing Services questions
Do you have to be our LIS for you to do our billing?
No, but the results are better when billing reads the same order record the laboratory ran. Where we bill against an external system, scope depends on the interface available for order and result data.
How is performance measured?
Measures are agreed at the start — typically clean claim rate, days in AR, denial rate by reason and collection against expected reimbursement. We do not publish guaranteed figures, because they depend on payer mix, documentation quality and the state of the existing AR.
Lab Data Entry
Trained staff handling registration, demographics, insurance and order entry against your workflow rules.
eFax Management
The inbound fax queue turned into a monitored pipeline: classified, extracted, validated and filed.
Results Management
Result processing, release support, delivery and reconciliation — including reference laboratory results.
Laboratory Operations
Consulting, implementation, workflow design and ongoing operational support across the laboratory.
The platform
The software these services run on.
Pricing
How services are scoped and quoted.
Ready to modernize your laboratory?
Whether you need a complete LIS, billing infrastructure, workflow automation, integrations, or managed operational support, let's build the right solution for your laboratory.